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Am J Med. 2014 Feb;127(2):152-7. doi: 10.1016/j.amjmed.2013.10.012. Epub 2013 Nov 1.

Identification of cardiometabolic risk: visceral adiposity index versus triglyceride/HDL cholesterol ratio.

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Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina. Electronic address:
Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina.
Hospital Municipal de Rauch, Buenos Aires, Argentina.
Stanford University School of Medicine, Stanford, Calif.



The plasma concentration ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) can identify cardiometabolic risk and cardiovascular disease. The visceral adiposity index is a sex-specific index, in which measurements of body mass index and waist circumference are combined with TG and HDL-C concentrations. The current analysis was initiated to see if the visceral adiposity index would improve the ability of the TG/HDL-C to identify increased cardiometabolic risk and outcome.


Cardiometabolic data were obtained in 2003 from 926 apparently healthy individuals, 796 of whom were evaluated in 2012 for evidence of incident cardiovascular disease. The relationship between TG/HDL-C and values for visceral adiposity index was evaluated by Pearson's correlation coefficient. The relative risks for first cardiovascular event between individuals above and below the TG/HDL-C sex-specific cut points, and in the top quartile of visceral adiposity index versus the remaining 3 quartiles, were estimated using Cox proportional hazard models.


TG/HDL-C concentration and visceral adiposity index were highly correlated (r = 0.99) in both men and women. Although more men (133 vs121) and women (73 vs 59) were identified as being at "high risk" by an elevated TG/HDL-C ratio, the individual cardiometabolic risk factors were essentially identical with either index used. However, the hazard ratio of developing cardiovascular disease was significantly increased in individuals with an elevated TG/HDL-C, whereas it was not the case when the visceral adiposity index was used to define "high risk."


The visceral adiposity index does not identify individuals with an adverse cardiometabolic profile any better than the TG/HDL-C.


Cardiovascular outcome; TG/HDL-C ratio; Visceral adiposity index

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